Diet and exercise are important parts of managing PCOS. This is because young women with PCOS often have higher levels of insulin (a hormone) in their blood, and many have trouble maintaining a healthy weight. Knowing the right foods to eat as well as the kinds of food to limit can improve the way you feel. It will also help you lose weight. Eating well, staying active, and maintaining a healthy weight (or losing even a small amount of weight if you’re overweight) can improve PCOS symptoms.

What do I need to know about insulin and carbohydrates?The insulin level in your blood goes up after you eat. It goes up the most after you eat or drink something that contains carbohydrates. Carbohydrates are found in grains (such as bread, pasta, rice, and cereal), most snack foods (such as chips, cookies, and candy), sugary drinks such as soda and juice, and fruits and vegetables.

Are all carbohydrates the same?No. Even if you eat two foods that have the same amount of carbohydrate, they may have a different effect on your insulin level. This effect has a lot to do with the type of carbohydrate the food has. Carbohydrate foods with fiber are usually the best to eat if you’re trying to keep your insulin level down. Carbohydrate foods that are sugary or refined (such as white bread and white rice) can cause insulin levels to go up. Foods such as these are also not very filling (which means you may feel hungry shortly after eating them). Try to choose high–fiber, low–sugar carbohydrate foods most of the time.

Do I need to buy special foods?No. You don’t need to go out of your way to buy special foods. Just like with any healthy diet plan, your meals should include a healthy balance of vegetables, fruits, whole grains, plant–based protein, lean meats, and healthy fats. Most foods fit into a healthy diet for PCOS, but you should read food labels to help you pick out the best choices. Look for high–fiber grains such as brown rice, whole–wheat pasta, and whole–wheat rather than low–fiber grains such as white rice, pasta, or white bread.

Don’t be fooled by fat–free treats. They usually have a lot of added sugar. Also, some sugar–free foods (such as baked goods) are made with refined grains such as white flour and can raise your insulin levels the same way sugar can. Other sugar–free foods have no effect on insulin because they are also carbohydrate free. These foods (such as sugar–free Jello®, diet soda, Crystal Light®, and sugar–free popsicles) are PCOS–friendly.

Instead of:

Sweetened juice, canned fruit in heavy syrup, or sweetened applesauce

Starchy vegetables such as potatoes, corn, and peas

Refined grains made with white flour such as white bread and pasta, bagels, or white riceSugared cereals such as Lucky Charms®, Fruit Loops®, or Frosted Flakes®, and other sweetened grains such as cereal bars (Nutrigrain Bars®), breakfast pastries (PopTarts®), and donuts

High fiber cereals such as Kashi®, shredded wheat, and All Bran®. (Look for cereals that have at least 5 grams of fiber per serving or sprinkle ½ cup of bran cereal or unprocessed bran on a low–fiber cereal to increase the fiber)

Sugar–free or low sugar drinks such as water, diet soda, Crystal Light®, Fruit20®, or seltzer water

Diet and exercise are important parts of managing PCOS. This is because young women with PCOS often have higher levels of insulin (a hormone) in their blood, and many have trouble maintaining a healthy weight. Knowing the right foods to eat as well as the kinds of food to limit can improve the way you feel. It will also help you lose weight. Eating well, staying active, and maintaining a healthy weight (or losing even a small amount of weight if you’re overweight) can improve PCOS symptoms.

Are “carbs” unhealthy? No! Carbs (carbohydrates) give your body energy. Some people think that eating carbs will make them gain weight, but carbs will make you gain weight only if you eat too many of them. Many other important nutrients come from carbohydrate foods, so eating no carbs is not a good idea. Because high–fiber carbohydrate foods are high in other nutrients and help you feel full longer than sugary carbohydrates, it’s best to choose these as often as possible.

What about foods that have fats and proteins in them?Protein foods such as beans, hummus, nuts, peanut butter, tofu, eggs, fish, chicken, meat, and vegetarian meat substitutes, and fats such as oil, salad dressing, and avocado are important parts of a PCOS–friendly diet. Combining foods that contain protein or fat with a carbohydrate will help to slow down the absorption of the carbohydrate and keep insulin levels low. For example, instead of plain rice, have rice with beans and a little avocado.

Keep in mind that some fats are much healthier than others. Healthy fats are found in olive oil, canola oil, nuts, avocados, and fish. Choose healthy fats and proteins instead of butter, margarine, mayonnaise, full–fat cheese, and red meat. Plant-based protein foods such as beans and nuts and lean proteins are all healthy options for girls with PCOS. There is some controversy about whether girls with PCOS should eat soy foods, like tofu and edamame. Some girls and women with PCOS choose to limit soy-foods, although there is little research to support this recommendation.

Do I need to follow a diet that is extra high in protein?No. Really high protein diets (such as the Atkins diet) are not a good diet option for teens because they can be low in some important nutrients such as fiber, the B vitamins, and vitamin C. It’s also important to remember that even if you limit your carbohydrate intake, overeating fat or protein can cause weight gain. You should aim for a diet that has a balance of protein, healthy carbohydrates, and some fat.

What does low glycemic index mean?Glycemic index is a term used to describe how a food affects blood sugar. The higher a food raises blood sugar, the higher the glycemic index. High–fiber carbs have a lower glycemic index than sugary or refined carbs. Combining a carbohydrate food with another food can lower the glycemic index because it allows your body to absorb the carbohydrate more slowly.

If I choose the right foods, do I still need to be worried about my portion sizes?Yes! How much you eat also affects your insulin. For example, your insulin will go up much more if you have 3 cups of pasta than if you have 1 cup of pasta. This means it’s usually better to have small meals and snacks during the day than it is to have a few really big meals. Having more smaller meals and snacks will keep your insulin level lower throughout the day.

The Nutrition Facts label explains what nutrients (components of food your body needs to grow and stay healthy) and how much of those nutrients are in found in one serving of the food. It’s located on the outside of most food packages, but isn’t on most fresh foods (such as fruits and vegetables or meats). The Nutrition Facts label can help you make choices about the food you eat.

What will every Nutrition Facts Label have on it?The label will have some or all of the following nutrients listed:

Serving Size: Serving size equals one serving of the product. All the other nutrient values listed on the label are based on this amount.

Cholesterol: Cholesterol is a substance found only in animal products. Eating too much cholesterol is not healthy for your heart.

Servings per Container: This number is how many servings you can get from one package. Some containers have a single serving, but most have more than one serving per package.

Sodium: Sodium is the amount of salt in the serving of food. People with high blood pressure are often told to follow a low sodium diet.

% Daily Value: This value is the percentage of the recommended daily value for a nutrient that you get in one serving. A food that has more than 20% of the Daily Value of a nutrient is an excellent source; however, for some nutrients such as fat, sodium, and cholesterol, the lower the percent, the better.

Total Carbohydrate: Carbohydrates give your muscles and brain energy. Certain types of carbohydrates are sometimes listed on the label.

Calories (total): Calories are a unit of energy that come from carbohydrates, protein and fat. Calories give us energy so we can think and be active.

Dietary Fiber: Helps with digestion and keeps you full between meals.

Calories from Fat: This number is the amount of calories that come from fat. It’s not the percent of fat in the food.

Sugars: Are important for instant energy, but eating too much added sugar can be unhealthy.

Total Fat: Fat is essential for our bodies. There are 4 kinds of fat. Monounsaturated and polyunsaturated fat are the kinds of fat that are healthy for the heart.

Protein: This nutrient is used to build muscle and fight infections.

Trans Fat: Trans fat is unhealthy for your heart, and should be avoided.

Vitamins and Minerals (A, C, Calcium, Iron): This amount is the percent (%) Daily Value for vitamin A, vitamin C, calcium, and iron you are getting from a serving of this product. Other vitamins and minerals may be included in this section.

Other nutrients, such as polyunsaturated or monounsaturated fat and other vitamins and minerals, can also be put on the Nutrition Facts label if the company that makes the food wants them listed.

What should I look for on the Nutrition Facts Label?The first thing you should look at is serving size. The amount of each nutrient on the label is what’s found in one serving of that food, not in the whole container. If you don’t know what one serving size is, you won’t know the amount of each nutrient you’re actually getting. For example, a large bag of microwave popcorn has three servings in it. It’s okay to eat more than one serving at a time, but it’s important to know that if you eat the whole bag, you’d be getting three times what’s listed on the label. Portion control is an important part of healthy eating for PCOS, so keep the serving size in mind.

Do I need to read every Nutrition Facts Label?No. You don’t need to keep track of every nutrient you are eating. Just take a look at Nutrition Facts labels once in a while to help you make healthy choices and choose foods that will give your body the nutrition it needs. For example, if you don’t drink much milk, you should read Nutrition Facts labels to help you find other foods that are high in calcium. You can also use the Nutrition Facts label to compare two different foods. For example, if you are deciding between two different kinds of breads, reading the Nutrition Facts labels can help you make a healthy choice. Consider choosing the bread that has the highest amount of fiber.

The food label lists a 2000-calorie diet. Should I be eating 2000 calories?It’s possible that a 2000-calorie diet may be right for you, but many adolescents need more than 2000 calories as they grow in height, build bones, build muscles, and stay active. The 2000–calorie diet is just an estimate and is used to help calculate the Percent (%) Daily Value listed on the Nutrition Facts label.

What does a Nutrition Facts label look like?Below you’ll find a sample Nutrition Facts label with a description of the items that you’ll find listed there.

Is it important for me to exercise?Yes! It’s really important that girls with PCOS exercise, because exercise brings down insulin levels, and can help with weight loss. Exercise can be especially helpful in lowering insulin after a meal. So, if possible, go for a walk after you eat a large meal. Any increase in exercise helps, so find an activity, sport, or exercise that you enjoy. If you aren’t doing a lot of exercise now, start slowly, and build up to your fitness goal. If you only exercise once in a while, try to exercise more regularly. Work towards increasing your physical activity to at least 5 days a week for 60 minutes per day.

Dairy?Dairy products can be included in a healthy PCOS meal plan as long as you are not lactose intolerant or allergic to milk. Low-fat milk, yogurt, and cheese are good sources protein and calcium and can be a healthy choice for many people, including those with PCOS. However, don’t feel like you have to include dairy in your meal plan if you don’t want to and are able to get calcium from other sources. Non-dairy sources of calcium include dark green vegetables, nuts, seeds, and fortified products such as orange juice and soy milk.

Nutrition Guidelines in PCOS (Polycystic Ovary Syndrome) Since the origin of most symptoms associated with PCOS is thought to be related to insulin resistance, nutrition guidelines and lifestyle recommendations are centered on treating insulin resistance and its long term health effects. The following recommendations have proven successful in treatment: 1. Weight Loss: even a 10% reduction in body weight will decrease insulin resistance. Try not to eat less than 1400 kcal/day. 2. Balanced carbohydrate intake throughout the day. Eat three meals with 45 grams/meal and two to three snacks of 15/20 grams each. (1400 kcal = 170 grams carbohydrate). (Individuals who are very active or vegetarian may need at least 60 grams of carbohydrate/meal). 3. Do not skip meals. Try not to let more than four to five hours go between meals/snacks to maintain stable blood sugars and diminish extreme hunger. 4. Gradually increase intake of high fiber carbohydrate foods, aiming for 30 to 35 grams/day, or 15 grams/1000 kcal. 5. Emphasize lean protein foods at 15 to 20% of total calories. (1400 kcal = 70 grams protein) Try to include protein with most meals and snacks. 6. Consume about 25 to 30% of calories as fat – emphasizing low saturated fat foods and increased monounsaturated and omega-3 fatty acid food choices. Avoid foods containing trans fats. 7. Include two to three servings of low fat dairy foods per day, such as skim or 1% milk, yogurt, lite cheese, cottage cheese etc. 8. Some phyto-nutrients might improve insulin resistance. Caissia cinnamon (500 to 1000mg in water soluble capsules or 1 to 2 tsp/day of the spice); low fat dairy foods; nuts especially walnuts; orange and leafy green vegetables such as spinach or kale; carrots, yams and sweet potatoes. 9. Vitamin D deficiency has been associated with insulin resistance and reduced pancreatic beta cell function. Supplementation with Vitamin D3 (cholecalciferol) may be beneficial. Consider taking 1500 IU of vitamin D3/day. 10. Control portions, especially from restaurants or fast food places. Most restaurant portions are 50% more than needed. Ask for the “to go” container when the meal arrives and put aside part of the meal. High Fiber carbohydrate foods include: whole grain breads, rolls, bagels; whole wheat pasta, brown and wild rice, high fiber cereals, oats, barley, legumes (peas, beans and lentils), corn, bran, seeds, nuts; fresh and dried fruit and most vegetables. B12 absorption may be affected by long term use of metformin. A multivitamin supplement with B12 is recommended, especially for strict vegetarians. Monounsaturated fat containing food choices include: avocado, canola, olive and peanut oils; olives, nuts such as almonds, cashews, peanuts and pecans; peanut butter, nut butters, sesame oil, seeds and paste. Omega-3 fatty acid (specifically EPA and DHA) containing food choices include: cold water fish such as salmon, mackerel, halibut, tuna, sardines and herring. Two to three servings of fatty fish/week will provide the 220 mg each of EPA and DHA that is recommended. Omega-3 eggs from free range chickens. Fish oil supplements containing 220 mg each of EPA and DHA per day. Typically, a 1000 mg fish oil capsule contains 180 mg EPA and 120 mg DHA. Flax seed is high in ALA which is normally converted to EPA and DHA. However people with insulin resistance may not efficiently make this conversion, so flax seed supplementation may not be beneficial. Limit foods containing trans fatty acids, especially deep fried restaurant foods and commercial products not labeled trans free. Lean protein food choices include: lean beef such as sirloin, top round, extra-lean ground beef, white meat of chicken and turkey, dark meat without the skin, pork loin, ham, center cut lamb and pork chops, game such venison, buffalo. Fish and shell fish; egg whites, egg substitutes, free-range eggs, skim and 1% milk, soy milk, low-fat yogurts, cottage cheese, low-fat or lite cheese, beef jerky. Dried beans, lentils, peas, hummus, soy products such as veggie burgers and meat substitutes, tofu. Nuts and seeds are higher in fat but contain healthy monounsaturated fats.

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